The evolution of the inspiring surgeon

Surgeons performing a thoracic operation in Billings Hospital at the University of Chicago, 1955 (Image: University of Chicago Photographic Archive, apf3-01144, Special Collections Research Center, University of Chicago Library.)

In the Middle Ages, formal medicine was practiced by academics and clergy who considered the vulgar cutting and bloodletting of surgery beneath them. Instead, surgery was practiced by tradesmen who happened to have razors, scissors and sharp knives at hand: barbers. In the days before anesthesia, surgery was a brutal practice, marked by the barber-surgeon’s speed as much as skill in pulling teeth, stitching wounds or even amputating limbs.

The modern surgeon has come a long way from the “sawbones” of the past—highly specialized, armed with years of training and the most advanced, precise tools and technology. In a new editorial in the Annals of Surgery, Peter Angelos, MD, PhD, the Linda Kohler Anderson Professor of Surgery at the University of Chicago Medicine, argues the modern surgeon needs to go beyond technical mastery and professionalism, however, to become an “inspiring surgeon”:

We propose that the professional goal for surgeons should be to become an “inspiring surgeon”—that is, a surgeon who inspires the confidence of our patients, the trust of our colleagues, and the satisfaction that comes with achieving excellence in patient care. These are the elements that make the practice of surgery a fulfilling profession. Though it may be a challenge, we maintain that these elements can be measured.

Peter Angelos, MD, PhD

Angelos, who is also Associate Director of the MacLean Center for Clinical Medical Ethics, has become a leading voice on surgical ethics, directing the first program in the nation dedicated to teaching residents, fellows and practicing surgeons how to untangle the tricky ethical problems posed by surgery. The ideal, modern surgeon, he writes in the new article, must rely on both skill and good judgment grounded in ethical concern for the patient’s wellbeing.

“We owe it to ourselves, and more importantly to our patients, to align our professional identity and the metrics by which we are judged,” he writes. “Each must strive to become the ‘inspiring’ surgeon, one who not only achieves high quality outcomes and deploys excellent clinical judgment, but who engenders trust in the patients we ultimately serve.”

The article, “Surgical Professionalism: The Inspiring Surgeon of the Modern Era,” was co-authored by Julia Berian, MD, surgical resident at UChicago Medicine, and Clifford Ko, MD, a surgeon from the University of California Los Angeles.